Plans for a new telehealth-powered “microclinic” in Terlingua are moving forward after local officials voted this month to approve a funding deal with a Houston-based company.
Board members of the Big Bend Regional Hospital District - a local public health entity - voted on Jan. 23 to help subsidize the plan by agreeing to pay $14,000 monthly payments to Hamilton Health Box, which would supply and operate a small prefabricated clinic. Patients visiting the clinic would see an in-person nurse but speak remotely via video screen with a doctor located elsewhere.
The company, founded in 2019 by West Texas native Toby Hamilton, has previously partnered with health care providers in the Houston area and Oklahoma on similar modular clinics. The firm announced in May of last year that it had raised $10 million from investors to “expedite” its model for rural areas, with the goal of providing “essential primary care in locations where sustainable health care services have been lacking.”
As the Big Bend Sentinel has reported, Terlingua currently only has a temporary grant-funded clinic operated by Preventative Care Health Services, though that company has been exploring ways to make the clinic a permanent location. Residents of south Brewster County often drive more than an hour for basic medical care and to access the region’s primary hospital in Alpine.
In an interview, Hamilton said the company is aiming to address a fundamental financial problem for rural health care.
“In rural America and underserved communities, the economics don’t work out for providers to exist there,” he said. “I believe it’s one of the only economically sustainable ways we’re going to get consistent health care into underserved communities like this.”
Brewster County may also contribute up to $200,000 for the modular clinic and allow it to be placed on county-owned land, according to County Judge Greg Henington, who said he’ll propose those measures at an early February commissioners court meeting.
Like much of the rest of Terlingua’s economy, the success of the Hamilton Health Box’s new clinic could depend on revenue from tourists.
Federal data shows more than 564,000 people visited nearby Big Bend National Park in 2024, a more than 10% increase from the year before, though still down from the park’s all-time record of 581,000 visitors in 2021.
Hamilton said tapping into the tourist market would be important.
“To be sustainable long-term, you need to get as much volume as you can,” he said. “That community’s really dependent upon tourism for survival, and we will be no different.”
Hamilton said while Brewster County’s potential additional funding assistance for the project would make “a huge difference,” his company is committed to getting the clinic started even if that funding falls through.
Lynette Brehm, the Big Bend Regional Hospital District’s executive director, said the goal is for the clinic to open by April. The clinic is expected to be open 5 days a week for a few hours a day. She also said that the clinic’s hours could shift seasonally to account for fluctuations in Terlingua’s population from the busy tourism season to quieter summer months.
The facility would have an on-site nurse capable of administering some basic services and doctors or specialists that would connect with patients on a large video screen.
“The clinic will take walk-ins, take appointments, be able to do vaccines, be able to do lab work,” she said.
Brehm said the hospital district’s monthly subsidy to Hamilton Health Box likely wouldn’t cover the company’s entire costs for the project.
“It’ll give them time to rev up, build a patient base, understand what the need is there in Terlingua,” she said.
